Dmitry V. Senyushkin

BACKGROUND: Obesity-associated bronchial asthma is a common and difficult-to-treat phenotype of adult asthma. Currently, asthma is classified into two major endotypes: Th2 and non-Th2. The non-Th2 endotype reflects a non-allergic inflammatory mechanism but lacks clearly defined laboratory criteria, unlike the Th2 endotype. In this context, P-selectin and the receptor for advanced glycation end products (RAGE) are of particular interest as potential markers of non-allergic inflammation. However, their role remains insufficiently studied. AIM: This study aimed to evaluate the role of P-selectin and the receptor for advanced glycation end products (RAGE) in the development of bronchial asthma in adults with obesity. METHODS: A cross-sectional consecutive study was conducted. Clinical characteristics, spirometric parameters, and immunological markers were assessed in patients with and without obesity, depending on the presence of bronchial asthma. Immunological markers were evaluated using enzyme-linked immunosorbent assay, including P-selectin, receptor for advanced glycation end products (RAGE), interleukin-4, interleukin-8, tumor necrosis factor alpha, and interferon gamma. RESULTS: 96 participants were divided into four groups: group I, patients with bronchial asthma without obesity (n = 29); group II, patients with bronchial asthma and obesity (n = 27); group III (control), normal-weight individuals (n = 22); group IV (control), individuals with obesity (n = 8). Comparative analysis between the two asthma groups revealed no substantial differences in the analyzed markers; however, both groups differed remarkably from the control group III. Median P-selectin levels in groups I and II were 57.49 (46.82–129.29) pg/mL and 114.4 (58.5–161.5) pg/mL, respectively, which were significantly higher than in the control group III: 44.99 (34.00–60.07) pg/mL (p 0.05). Elevated levels of RAGE and TNF-α were also observed, indicating the presence of a systemic inflammatory response associated with obesity in patients with bronchial asthma. CONCLUSION: The study demonstrated substantial similarity of immunological responses in bronchial asthma and obesity. In the presence of both conditions, P-selectin demonstrated the most specific response, confirming the neutrophilic nature of inflammation.

Aim   Analysis of literature on the effect of telemedicine technologies on the adherence of patients with chronic heart failure (CHF) to therapy at the outpatient stage of treatment. Material and methods Publications were searched for in PubMed, Web of Science, Scopus, CyberLeninka, and Google Scholar using the key terms "telemedicine technologies," "remote monitoring," "commitment to treatment," "mobile applications in treatment," "telemedicine," and "telemonitoring." Reports were selected (January 2015-January 2025) independently by two researchers who reached a consensus. Based on the selection of literature sources, four studies that met the search criteria were included in the meta-analysis. The analysis was performed with the Review Manager 5.4.1 and Comprehensive Meta-Analysis 3.0 software using the fixed-effects model (inverse variance method). The results were visualized using a forest plot. Heterogeneity assessment included the Q-test and the I2 index (criterion: Results   The overall adherence rate in the reviewed studies was 64.8% (79/122 patients) in the telemonitoring group and 59.2% (74/125 patients) in the standard observation group, for a total of 61.9% (153/247 patients). Thus, the relative risk of treatment adherence was 1.10 (95% confidence interval (CI) 0.91-1.33; p=0.33). When assessing the homogeneity of the studies with the Pearson’s chi-square test, a statistically non-significant result was obtained (Pearson’s chi-square 2.74 with a degree of freedom of 2, p=0.25), and the heterogeneity index I2=27%, which determines the low heterogeneity of the studies. To identify systematic errors in the studies that used telemonitoring and the standard approach, funnel plot data were accounted for, which indicated an asymmetric distribution of data. Conclusion Telemonitoring with mobile apps and wearable devices is beneficial for patient adherence to treatment. Active implementation of these technologies is required to improve the monitoring of the use of prescribed therapy by patients with CHF.

Aim. To analyze literature data on use of photoplethysmography (PPG) at the outpatient stage for remote monitoring of heart rate, arrhythmias, blood pressure (BP), temperature, respiratory rate.Research design. The search was carried out using the PubMed/Medline, Web of Science, Scopus and Google Scholar databases from 2015 to 2025.Results. A small number of studies were included in the meta-analysis. Mean values of systolic and diastolic BP depending on the measurement method used were presented in two studies, which implies high inconsistency in the presented studies and determines the need for a balanced interpretation of the pooled estimate of the difference in mean values for these studies.Absolute values determining the incidence of AF are indicated in four studies.Conclusion. Our systematic review and meta-analysis showed PPG effectiveness for arrhythmia and controlling systolic and diastolic BP at the outpatient stage.